Steve Ruffenach: Footprints old and new

steve_ruffenachA recent discovery of ancient footprints on the beach in Happisburgh, UK has set the archeological world aflutter. Scientists working at the scene have discovered pre-historic footprints left by our ancestors some 850,000 years ago. As reported by PLOS One, the details of the findings have challenged some long-standing beliefs regarding ancient human behavior and migration.

It is interesting to note that the archeologists who found the footprints did so without much, if any, help from their always-on, omnipresent assistant Tech. No scanner of sorts to guide the scientist, no eye in the sky interpretation of land mass patterns. Rather, all they had was a practiced eye and a keen sense of suspicion that valuable discoveries might be afoot.

Indeed, in photos taken at the scene, it appears to an untrained observer that the beach is simply studded with random potholes and mounds left by centuries of water and wind. But the archeologists, trained in discovery techniques and knowledgeable that Happisburgh held historic surprises, saw those bumps through a different lens; one that was focused on ancient secrets and ready to recognize what others could not.

Once discovered, field professionals immediately put their ever-present aide-de-camp, Tech, to work. Using both multi-image photogrammetry (MIP) and laser-scanning techniques, Tech measured, clarified, and recorded every possible aspect of the prints.

It is important to note that Tech didn’t discover the footprints, people did. At the scene, professionals did their job and then Tech did his. Tech complemented the work of people, he did not, and could not, replace them.

Ancient Homo antecessors weren’t the only ones who have left historical markers behind. Patients in our clinics and hospital beds commonly leave footprints of a different sort waiting to be discovered and ponder.

The footprints our patients create today come in many forms. Physical footprints such as scars and oversized hearts and swollen livers may well tell of a past of which the patient may be reluctant to admit. Digital footprints of all sorts—blood pressure measurements, lab results, radiology studies—often are left unnoticed or unremembered by patients as they try to navigate the vast and seemingly muddy modern medical world.

Such prints, some created and held by the patient, others by Tech, are waiting to be discovered by a curious and keen-eyed clinician who knows where and how to discover and interpret a patient’s health issues.

Modern healthcare professionals need to consider themselves archeo-clinicians, charged with the responsibility to find these records, recognize their importance, and stand ready to weigh, sort, and act on them for the benefit of our patients.

And then, once revealed, let Tech do his job of measuring, storing, integrating, and transporting the data to the discovering physician and associates.

We need to teach our doctors in training, and remind more seasoned clinicians, how and where to look for clues that untrained eyes would find unremarkable. Bumps in the riverbed and bumps in our patient’s bodies and charts may well carry secrets that only the well-trained and astute specialist will see.

We also need to impress on our young colleagues that their new always-on, always ready, seemingly all-knowing medical assistant named Tech, will do his best work when he remains in the background following our clinical lead.

Our patients are best served when we allow doctors to do the heavy lifting—discovery and interpretation—and leave to Tech nothing more than to deal with data and digits.

Our profession is best served when we keep Tech in his place working as a subordinate to our imagination and intuition.

Steve Ruffenach is an internist and medical informaticist living and practicing in Tucson, Arizona, USA. He holds a teaching position as a clinical assistant professor of medicine at the University of Arizona and has a keen interest in medicine and machines.

Competing interests: None declared.

  • Larry Perfetti

    Dr. Ruffenach wisely establishes the fact that the physician is the clinician-investigator-healer and that technology serves the purpose of helping doctors pursue further clinical data to test the doctor’s very human hypotheses. Technology provides a set of powerful tools 6
    null to answer questions and to test clinical hypotheses that arise in the minds of experienced clinicians. Well-put, Dr. Ruffenach.